Mental Health, Impact of Trauma on Health Care Professionals During COVID-19

A large proportion of the world was rattled with the appearance of coronavirus disease 2019 (COVID-19) in the latter part of 2019. Prior to the inception of COVID-19, many people had not experienced a pandemic in their lifetime, so it quickly became a life-changing event.

When the virus was initially isolated in Wuhan City, China, around December 2019, there was not the immediate thought that it would ultimately spread across the globe to cause widespread deaths and change people’s lives for the foreseeable future.

Prior to the recent outbreak of COVID-19, most Americans were aware of another type of the coronavirus, severe acute respiratory syndrome (SARS) in 2002, which stemmed from an outbreak in Guangdong Province of China and lead to 8098 cases and contributed to 774 deaths.

However, the magnitude of that outbreak does not compare to what has been experienced with COVID-19.¹ Similar to SARS, COVID-19 initially affected individuals who were elderly or had a compromised respiratory system; however, this target population also began to change as time went on to present in both the young and old.

The rapid spread of the COVID-19 virus in Wuhan lead to an evacuation of the city, which began the chain of steps and measures that were taken by other governing bodies across the world to attempt to contain the spread of the virus.² As the virus began to spread across the globe, the responsibilities of care fell on health care professionals, including pharmacists. Along with the duty to care was also the psychological burden that developed in these frontline professionals.³

The spread of the virus contributed to associated morbidity and mortality, but also lead to the development of mental health issues and even trauma from lived experiences among health care professionals at the center of the pandemic.³ The first occurrence of this impact was seen in Wuhan, China, where health care professionals on the frontlines were experiencing an alarming rate of insomnia, stress, anxiety, and depression.⁴

Some of these health care professionals were providing care on an ongoing basis, and therefore risked exposing themselves to the virus and, thus, psychological symptoms would develop or be further exacerbated as a result.

During the height of the COVID-19 pandemic, health care professionals were faced with shortages of personal protective equipment, which only increased their risk of contracting the virus. They also worked long, difficult hours that produced feelings of burnout. Ultimately, the consistent barrage of these issues would lead some professionals to quit their jobs out of fear of either contracting the virus and the associated mental health toll.

Based on the evaluation of smaller scale epidemics and what health care professionals are facing in the midst of COVID-19, there can be an associated increase in psychological morbidities.⁵ A notable issue that developed, according to a web-based questionnaire conducted between March 27 and 31, 2020, was the presence of post-traumatic stress disorder (PTSD) resulting from the traumatic experiences of treating patients with COVID-19.

This questionnaire was presented to Italian health care workers, whose country was hit especially hard by the pandemic and who were working in front- and second-line positions.⁶ The study was able to confirm what was identified in China and a strong relationship with the mental health of health care workers, which was relevant during the pandemic.⁶

In order to combat the mental health distress and trauma that continues to arise during this pandemic, the key is the ability to immediately identify presenting symptoms and to act accordingly to provide treatment. Health care professionals, such as pharmacists, will remain a staple of the COVID-19 pandemic. Therefore, in order for them to continue to effectively tackle the virus and treat patients, their own mental health and the possibility of psychological burden should be evaluated on an ongoing basis.

References

• Fehr AR, Perlman S. Coronaviruses: an overview of their replication and pathogenesis. Methods Mol Biol. 2015;1282:1—23. doi:10.1007/978-1-4939-2438-7_1
• Ryan J & Reichert C. Coronavirus timeline: How the disease spread across the globe from Dec. 2019 into March 2020. C/NET. Retrieved from https://www.cnet.com/news/coronavirus-timeline-how-the-disease-spread-across-the-globe-december-2019-into-march-2020/
• Spoorthy MS, Pratapa SK, Mahant S. Mental health problems faced by healthcare workers due to the COVID-19 pandemic-A review [published online ahead of print, 2020 Apr 22]. Asian J Psychiatr. 2020;51:102119. doi:10.1016/j.ajp.2020.102119
• Lai J, Ma S, Wang Y, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open.2020;3(3):e203976. doi:10.1001/jamanetworkopen.2020.3976.
• Tsamakis K, Rizos E, J Manolis A, et al. COVID-19 pandemic and its impact on mental health of healthcare professionals. Exp Ther Med. 2020;19(6):3451-3453. doi:10.3892/etm.2020.8646
• Blankenship B. How COVID-19 affecs the mental health of healthcare workers. Medical News Bulletin. Retrieved from https://medicalnewsbulletin.com/covid-19-and-mental-health-of-healthcare-workers/